Objective: To evaluate the efficacy and safety of CHOP regimen based on doxorubicin hydrochloride liposome in the initial treatment of elderly patients with diffuse large B-cell lymphoma (DLBCL).
Methods: Thirty-one patients with DLBCL treated from January 1, 2012 to December 31, 2019 were analyzed retrospectively, their median age was 83 (71-95) years old, and all of them were in Ⅲ-Ⅳ stage, including 17 cases who had international prognostic index (IPI) ≥ 3. The patients were treated with R-CHOP and CHOP regimens based on doxorubicin hydrochloride liposome. The efficacy and safety were evaluated during and after treatment.
Results: A total of 219 chemotherapy cycles and 7 median cycles were performed in 31 patients. The overall response (OR) rate and complete remission (CR) rate was 80.7% (25/31) and 61.3% (19/31), respectively, as well as 2 cases (6.5%) stable, 4 cases (12.9%) progressive. The main toxicities were as follows: the incidence of grade Ⅲ -Ⅳ neutropenia was 29% (9/31); two patients (6.5%) developed degree Ⅰ-Ⅱ cardiac events, which were characterized by new degree Ⅰ atrioventricular block; there were no cardiac events requiring emergency treatment and discontinuation of chemotherapy. The 1-year, 2-year and 3-year overall survival rate was 83.9%, 77.4% and 61.3%, respectively. The 1-year, 2-year and 3-year progression-free survival rate was 77.4%, 64.5% and 61.3%, respectively.
Conclusion: The chemotherapy regimen based on doxorubicin hydrochloride liposome has better efficacy and higher cardiac safety for elderly patients with DLBCL.
题目: 以盐酸多柔比星脂质体为基础的CHOP联合方案治疗初治高龄弥漫大B细胞淋巴瘤患者的回顾性研究.
目的: 评价以盐酸多柔比星脂质体为基础的CHOP联合方案治疗初治高龄弥漫大B细胞淋巴瘤（DLBCL）患者的有效性和安全性.
方法: 回顾性分析2012年1月1日至2019年12月31日本中心血液科收治的初治DLBCL患者31例，中位年龄为83（71-95）岁，均为Ⅲ-Ⅳ期患者，国际预后指数≥3分患者为17例。治疗方案采用以盐酸多柔比星脂质体为主的R-CHOP及CHOP方案。在治疗过程中和治疗后对其疗效和安全性进行评价.
结果: 31例患者共进行219个化疗周期，中位周期7个，总缓解率和完全缓解率分别为80.7%（25/31）和61.3%（19/31），疾病稳定2例（6.5%），疾病进展4例（12.9%）。主要毒副反应为：Ⅲ-Ⅳ级中性粒细胞减少症发生率为29%（9/31）；2例（6.5%）患者出现Ⅰ-Ⅱ度心脏事件，表现为新发的Ⅰ度房室传导阻滞；未出现需要紧急治疗和中止化疗的心脏事件。1、2、3年的总生存率分别为83.9%、77.4%和61.3%，无进展生存率分别为77.4%、64.5%和61.3.
结论: 对于高龄DLBCL患者，以盐酸多柔比星脂质体为主的化疗方案疗效较好，患者心脏安全性较高.